Considering a MD/PhD over a PhD

[LycianPenguin]

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Hello All,

First off, I apologize if this has already been discussed in-depth elsewhere (I'm sure it has been touched upon many times already). As you can tell, I'm new here and, from my perusing the last few days, I wasn't able to establish the proper decorum for this sorta thing so I figured creating a new thread wily-nilly would be the lesser of two evils compared to hijacking someone else's.

As for the issue at hand. Back in my HS days, there used to be something called "Science Research" - basically, start off by reading 10 journal articles a week, discuss them, progress to presenting a couple during the year, and if you were dedicated and lucky enough, you got yourself working in someone's lab. I gravitated towards JI and JCO and got interested in immunology, in particular cancer immunotherapy. Ended up working two summers in an allergy lab (not exactly what i hoped for, but I was a HS junior when I started off so it was pretty cool for me); the first year yielded my name on two abstracts, first author on one, and a first-author publication still in the works (originally supposed to revise, instead currently beefing it up with new data which will make it fall under a lengthier type's guidelines); second year I was working on software that would improve calculating results from ELISAs, so nothing in print about that. In any case, I entered my freshman year thinking I would go the PhD track for immunology.

Well, I'm still a college freshman, but why am I now considering a MD/PhD?

-As you may have expected, I'm taking into consideration financial stability. I worked during a dry grant season, and a labmate got laid off while I was there; not sure how much the pinch is felt by the PI's. Also, I'm aware that an MD/PhD doesn't suddenly make my paycheck jump by, say, 50%; I've heard somewhere here that the ratio of MD work you do to PhD work you do is related to the ratio of MD-level salary to PhD-level salary you get.

-I'll admit that one of the reasons I had ruled out becoming a doctor some years ago was because I'm not, how should we say, a people person (in terms of bedside manner, think House). However, I realize that the human element cannot be undervalued. Knowing that test subject #0027698 had a 68% reduction of the intramuscular target lesion is important, but so is knowing that Henry can go back to playing the cello because his tremors have stopped. I don't mean to say that people are just statistics to PhDs, but that physician role probably helps keeps the goal of helping people live their lives in focus.

-Also, I tend to be obsessive. I always manage, control, and oversee things from the concept through the execution. I suppose that could partially apply to translational research.

And now for why I'm still on the fence.

-Well, I don't want get so tied up doing clinical duties that I'll end up spending no time in the lab. However, I am willing to spend a reasonable amount of time doing non-research work; after all, the heavier half my check will be coming from there. I'll just need to find a balance - and hopefully an employer that will let me work with that balance.

-Dang that's gonna take some time. 7-8 years is alright, but then factoring in residency/postdoc... But, I suppose that's the price you pay for a full training in two doctorates.


Anyways, I suppose that some of you have been in a similar situation (and even if you haven't), and I would appreciate your thoughts on this.

 

[tr]

I am SO GLAD I did the dual degree. I went in all gung-ho for science and didn't even consider or apply for straight-MD programs. I thought of the MD as kind of an adjunct, an extra knowledge base that would usefully inform my research.

Somewhere between my disillusionment with the biomedico-industrial complex and my surprising discovery that I actually loved clinical work (despite not previously having considered myself 'a people person'), I am d@mn glad I did both degrees. I look at my post-PhD colleagues who are scattering to the four winds of law school, med school, consulting, and big pharma, and think TBFTGOGGI.

Regarding the time spent, actually it doesn't end up being that different. At my program MD-PhD students were forgiven the lecture year of the PhD (so we started research in year 3 whereas PhD students started it in year 2). Most people did 4-5 years of real research; then the MD-PhDs went back to the clinic and the PhDs went into this holding phase where they were still knocking about in the lab while they looked for jobs. Overall time to both degrees was 7-9 for MD-PhDs and 5-9 for PhDs. Not too many PhDs out in 5 though - 6 or 7 was more the norm, and 7-8 for MD-PhDs.

The bottom line is that the dual degree gives you an inordinate amount of flexibility. It lets you sit on the fence a little bit longer while you really test the waters of both medicine and research, and lets you make an informed decision on either or both without saddling you with a debt that would limit your options.

I am not sure it ends up being such a good deal for the NIH or the scientific community at large; but for the individual there are a lot of benefits.

 

[greg12345]

The flexibility in career choices is HUGE, not saying that that is a good reason to do the dual degree, but the benefit/advantage of it cannot be overstated enough. Now the price you pay (in terms of time and emotional agony and, um, residency) for that is steep.

The problem with this whole scenario is that we are expected to make (for the most part) uninformed choices about our future career paths while we are sophomores/juniors in college. I recommend everyone educate themselves as best as they can what a career in science and a career in medicine entails, but let's face it, some things in life you just have to experience to really know what they are all about. I started my MD/PhD with the notion that 100% for sure I was going to do this and that when I finished, now that I am in residency those notions have changed 180 degrees, my research area of interest has changed, my chosen specialty/subspecialty track is different from the one I envisioned, and obviously my future career goals have changed as well. Believe it or not, life is different when you are 30 vs. when you are 22 - I owe the flexibility to do the things I love in the future to my training.

 

[LycianPenguin]

Thanks for sharing your experiences, tr and greg. I wasn't too sure if there was a gap between getting a PhD and a postdoc, so that's good to have clarified. Also, I agree with greg's latter point; I mean, I'm probably overthinking it for a freshman, but I'm already worrying "Hmm, which semesters can I free up to do hospital work. But, wait, what if I don't go that track, that's a semester less that I could have spent in the lab..."